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[Reversible blindness caused by an invasive prolactinoma]
B Schöfl-Siegert1, G Brabant, A von zur Mühlen
1Abteilung Klinische Endokrinologie, Medizinische Hochschule Hannover. schoefl.christof@mh-hannover.de
Deutsche Medizinische Wochenschrift (1946)
|June 21, 2001
Summary
A large skull base tumor causing sudden vision loss was diagnosed as an invasive prolactinoma. Dopamine agonist therapy rapidly shrunk the tumor and restored vision, making it the preferred treatment.
Area of Science:
- Neuro-oncology
- Endocrinology
- Ophthalmology
Background:
- A 40-year-old male presented with acute blindness, severe headache, and nausea.
- Imaging revealed a large skull base tumor causing increased intracranial pressure.
Observation:
- Endocrine tests showed partial hypopituitarism and moderate hyperprolactinemia.
- Initial biopsy suggested carcinoma, but final diagnosis was invasive prolactinoma.
Findings:
- Dopamine agonist therapy normalized prolactin levels and improved visual disturbances.
- Magnetic Resonance Tomography (MRT) demonstrated significant tumor shrinkage within 5 weeks.
Implications:
- Invasive prolactinoma should be considered in the differential diagnosis of acute visual loss due to skull base tumors.
- Dopamine agonist therapy is the primary treatment for prolactinoma, leading to rapid tumor reduction and symptom improvement.
- Serum dilution is crucial to avoid hook-effect errors in prolactin assays during diagnosis.